Indonesian Journal of Pharmaceutical Education
Vol 6, No 1 (2026): January–April 2026

Flipchart-Based Education Improves Antibiotic and Antimicrobial Resistance Knowledge Among Rural Elementary Students: A Pre-Experimental Study

I Gusti Ayu Rai Widowati (Department of Clinical Pharmacy, Faculty of Health Sciences, Bali International University, Denpasar, Bali, Indonesia)
Ida Ayu Manik Partha Sutema (Department of Clinical Pharmacy, Faculty of Health Sciences, Bali International University, Denpasar, Bali, Indonesia)
Ni Komang Semara Yanti (Department of Health Information Management, Faculty of Health Sciences, Bali International University, Denpasar, Bali, Indonesia)
I Wayan Agus Gede Manik Saputra (Department of Clinical Microbiology, Bali Mandara Hospital, Denpasar, Bali, Indonesia)
Ni Nyoman Sri Budayanti (One Health Collaborating Center, Faculty of Medicine, Udayana University, Denpasar Bali, Indonesia)



Article Info

Publish Date
18 Apr 2026

Abstract

Antimicrobial resistance (AMR) remains a major public health challenge, driven in part by inappropriate antibiotic use and limited public understanding of antibiotics and AMR. Early educational interventions for school-aged children may offer a sustainable approach to strengthening antibiotic literacy and promoting responsible health behaviors. This study evaluated the effectiveness of a flipchart-based educational intervention in improving elementary school students’ knowledge of antibiotics and understanding of AMR in a rural area of Bali, Indonesia. A pre-experimental one-group pretest-posttest design was conducted among 76 students using a validated questionnaire covering basic antibiotic concepts, AMR mechanisms, and prevention strategies. The proportion of students categorized as having high knowledge increased from 19.7% (95% CI: 11.8–27.8) before the intervention to 63.8% (95% CI: 53.9–75.3) after the intervention, while the proportion with low knowledge decreased from 21.1% to 10.5%. Mean knowledge scores increased significantly from 58.82 ± 16.57 to 75.13 ± 18.00, with a mean difference of +16.32 (95% CI: 12.55–20.08; p 0.001). The intervention also demonstrated a large practical effect (Cohen’s d = 0.99). These findings indicate that flipchart-based education can effectively improve antibiotic knowledge and AMR understanding among rural elementary school students and may serve as a promising school-based health education approach to support early antibiotic literacy.

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Journal Info

Abbrev

ijpe

Publisher

Subject

Biochemistry, Genetics & Molecular Biology Chemistry Materials Science & Nanotechnology Medicine & Pharmacology

Description

ndonesian Journal of Pharmaceutical Education (IJPE) adalah junal resmi yang diterbitkan oleh Jurusan Farmasi Universitas Negeri Gorontalo yang bekerja sama dengan IAI (Ikatan Apoteker Indonesia) Provinsi Gorontalo. Artikel pada jurnal ini dapat diakses dan unduh secara online oleh publik (open ...